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6 Things a Urologist (At Least One Like Me) Would Never Do

March 25, 2023

Andrew Siegel MD 3/25/2023

1. I would never smoke cigarettes or vape.

Tobacco use is the leading preventable cause of cancer. It is directly responsible for lung, head and neck, esophageal, stomach, kidney, pancreatic, cervical, and colon cancers. Carcinogens (cancer-causing chemicals) from tobacco bathe the surface of smokers’ urinary bladders, giving rise to bladder cancer many years after exposure. Tobacco is in fact the number one cause of bladder cancer, a common problem that I and other urologists treat on a daily basis. Aside from the cancer risk, tobacco causes serious cardiovascular and pulmonary issues and wreaks havoc on virtually every cell, tissue, and organ in the body. It is also one of the leading causes of erectile dysfunction.

2. I would never omit cancer screenings.

Cancer screening is vital because many cancers simply are not symptomatic early on in their course and early detection through screening will increase the likelihood of cure. This is particularly true for prostate, colon, and breast cancer. I have had a digital rectal exam and PSA blood test every year since age 40, and a colonoscopy every 5 years since age 50 (although the recommended starting age is now 45.)

3. I would never use unnecessary dietary supplements.

Recent studies have shown that vitamins and supplements are a waste of money for most people. They have been rarely proven beneficial and at times have been found to be harmful, e.g., beta-carotene may increase the incidence of lung cancer in those at risk and vitamin E may increase the risk for hemorrhagic stroke. Excess vitamin C is a leading cause of kidney stones. Vitamin C is a water-soluble vitamin that is not stored in the body, so it ends up in the urine in the form of oxalate, one of the key constituents of the most common kidney stone — calcium oxalate.

Micronutrient (vitamins and minerals needed by the body) supplements in isolation behave differently in the body than natural micronutrients present in whole fruits and vegetables that contain a cocktail of vitamins, minerals, fiber, phytochemicals, and other nutrients that likely act synergistically to provide health benefits. So, in general, you are better off getting your vitamins and micronutrients from natural food sources as opposed to from a box of pills.

The exceptions concerning vitamins and supplements are in children, pregnant women, certain illnesses, poor diet, and for those with specific deficiencies that need to be corrected, e.g., use of calcium and vitamin D to prevent fractures, iron to prevent/treat anemia, etc. I have low levels of Vitamin D, like many who reside in winter climates, and therefore use a Vitamin D supplement.

I would never use the myriad of prostate and other herbal supplements that are advertised on television. Supplements are often impure, contaminated, and ineffective. They are not under the domain of the FDA and therefore not subject to the regulation and scrutiny normally directed towards FDA-approved pharmaceutical products. Furthermore, when a problem surfaces with one of these products, the FDA will do no more than issue consumer alerts and request a voluntary recall.

The bottom line is that one’s resources are better spent on nutritious foods and quality workout shoes since healthy eating and exercise are evidence-based practices, as opposed to the supplements with their supposedly magical properties.

4. I would never drink 8-12 glasses of water per day, unless…***

Drinking excessive amounts of water is not healthy, necessary, or advisable and those that heed the advice of lay magazines that advise consuming 8-12 glasses of water daily might end up in a urologist’s office because of the urinary urgency, frequency, and nighttime sleep interruptions that result. Please see this excellent NY Times science section article: How Much Water Do You Actually Need?

*** The only circumstance in which I would drink this kind of volume of fluid is if I was severely dehydrated; this has only happened to me a few times in my lifetime and always as a result of prolonged, strenuous physical activities on extremely hot and humid days.

5. I would never ignore a chance to be physically active.

On so many levels, exercise is vital and imperative for our physical health and wellbeing, so I try to carve out the time to exercise daily. Fortunately, I have exercise equipment in my basement, so there are no excuses. However, on occasion I find it impossible to find the time to exercise, so on those rare times I try to integrate segments of exercise during daily activities. I walk the stairs instead of taking the elevator or escalator, stand up instead of sitting when seeing patients, take a walk at lunch instead of sitting for 30 minutes, etc. Other means of integrating exercise into daily activities include pulling one’s own luggage at the airport, parking far away from destinations and walking, opening cans and wine manually instead of using fancy appliances to do so, walking the golf course, pursuing gardening and yard work, shoveling the snow, walking the dog, cycling to do errands, etc., anything to keep moving. See my previous blog on integrational exercise: Walk the stairs, delay the inheritance to your heirs.

6. I would (almost***) never consume excessive amounts of processed foods, sugar, fast foods, red meats, dairy, and alcohol.

Healthy eating is a foundation of wellness, and our diet provides us with the fuel, energy, and the raw materials and nutrients that our body needs to replenish cells and tissues that are constantly turning over. We are literally what we eat and what we eat eats. The all-too-common Western diet — calorie-rich, nutrient-poor, loaded with processed and ultra-processed junk and fast foods, sweets, and liquid carbohydrates — is a key factor contributing to avoidable chronic health issues, including diabetes, cardiovascular disease, and cancer. A nutrient-dense diet with an abundance of whole, largely plant-based foods and a limited intake of harmful processed foods will promote health and wellness and can prevent, treat, and even reverse many chronic diseases. See my previous blog: What is the best diet?

There is mounting evidence that even small amounts of alcohol may have serious health consequences. Our bodies metabolize alcohol into acetaldehyde, a chemical that is toxic to cells and that can damage DNA. Aside from alcohol use being associated with car accidents, poisonings, homicides, it is also responsible for liver and heart disease as well as multiple cancers, including head and neck, esophageal, liver, breast, colorectal, prostate, and pancreatic cancer. Everything in moderation!

That was dinner last night, barbecued salmon and brussel sprouts, delicious and healthy

*** I’m not “perfect,” but strive to be “good” and eat a healthy diet most of the time. I am a big fan of the 80/20 or 90/10 diet: eating healthy 80-90% of the time and giving yourself some leeway 10-20% of the time. My daughter baked a delicious pecan pie this week and I enjoyed it immensely. Life is short and everything in moderation, including moderation!

Pecan pie, last night’s dessert, delicious and not so healthy

Wishing you the best of health,

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Dr. Andrew Siegel is a physician and urological surgeon who is board-certified in urology as well as in female pelvic medicine and reconstructive surgery. He is an Assistant Clinical Professor of Surgery at the Rutgers-New Jersey Medical School and is a Castle Connolly Top Doctor New York Metro Area, Inside Jersey Top Doctor and Inside Jersey Top Doctor for Women’s Health. His mission is to “bridge the gap” between the public and the medical community. He is a urologist at New Jersey Urology, one of the largest urology practices in the United States. He is the co-founder of PelvicRx and Private Gym. His latest book is Prostate Cancer 20/20: A Practical Guide to Understanding Management Options for Patients and Their Families.